Restor Dent Endod.  2016 Aug;41(3):182-188. 10.5395/rde.2016.41.3.182.

Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

• Kim D
• Ha JH
• Jin MU
• Kim YK
• Kim SK

• KMID: 2346766
• DOI: http://doi.org/10.5395/rde.2016.41.3.182

Abstract

OBJECTIVES
The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery.
MATERIALS AND METHODS
Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT.
RESULTS
The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01).
CONCLUSIONS
For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

Keyword

Apical surgery; Apicoectomy; Buccal bone thickness; Cone-beam computed tomography; Mandibular molar; Root apex

MeSH Terms

Apicoectomy
Cone-Beam Computed Tomography
Humans
Molar*
Tooth

Figure

• 

  Figure 1 Mandibular axial cone beam computed tomography (CBCT) images for measurement. (a) The distance from the first molar apex to the buccal bone surface; (b) The distance from the disto-lingual root apex of the first molar to the buccal bone surface; (c) The distance from the C-shaped second molar apex to the buccal bone surface; (d) The distance from the buccal root surface at the apical 3 mm to the buccal bone surface with a C-shaped root.

• 

  Figure 2 Mandibular axial cone beam computed tomography (CBCT) images for mandibular second molars. (a) The distance between the second molar apex and the buccal bone surface, when the first molar is present; (b) The distance between the second molar apex and the buccal bone surface, when the first molar is absent.

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